FULL TIME COLLEGE APPLICATION (Vocational Undergraduate - Graduate)

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1 The Confederated Tribes of the Grand Ronde Community of Oregon, Education Division Higher Education Programs (503) FAX (503) Grand Ronde Road Ext Grand Ronde, OR Umpqua Molalla Rogue River Kalapuya Chasta FULL TIME COLLEGE APPLICATION Please Check One of the Following: Vocational Degree/Certificate Associate Degree Bachelor Degree Graduate Degree The Confederated Tribes of Grand Ronde Education Division administers a Full Time College Program that provides funding to Grand Ronde Tribal members pursuing a Vocational Degree or Certificate, Associate, Bachelor, or Graduate Degree on a full time basis from a nonprofit regionally accredited institution (see Full Time College Program policy for a list of approved regional accrediting agencies). All educational institutions are subject to review and approval by the Education Division prior to providing funding for Tribal member participation. The program funding limits are as follows: Vocational or Technical College/Institute or Community College $2,400 per term or $3,600 per semester 4 year College or University (bachelor degree seeking) $4,000 per term or $6,000 per semester Graduate Level $6,000 per term or $9,000 per semester The following documents must be received by the deadline date along with the completed application to be considered for funding: Copy of CTGR Tribal Enrollment Card/Certificate of Indian Blood (CIB) Copy of High School Diploma or GED Completion (vocational, associate, bachelor degree students only) Copy of Bachelor Degree (graduate degree students only) Copy of your Student Aid Report (SAR) This report is a summary of the information you submitted on your FAFSA can be retrieved at Signed Funding Acceptance Agreement (page 4) Educational Goals (page 5) Signed Authorization for Release of Information (page 7) Scholarship Application Requirement (page 8) Copy of Verification of Application for an Outside Scholarship Copy of Schedule for the Term / Semester you will be attending Please return completed application and verifications to: The Confederated Tribes of Grand Ronde Higher Education Programs 9615 Grand Ronde Road Grand Ronde, OR Complete applications must be received at the Education Division office at least 30 days before the beginning of the term/semester for which you are requesting funding. You can submit your application before you are registered for classes. Please contact the Higher Education Programs at x2275 if you any questions about this application or the Full Time Program.

2 Please Check One of the Following: FULL TIME COLLEGE APPLICATION Vocational Degree/Certificate Associate Degree Bachelor Degree Graduate Degree The information in this application is being collected to determine eligibility for participation in the Higher Education Programs Full Time College Program. The applicant must provide the required information for consideration of the application. Incomplete information and/or false statements will subject this application to rejection for this program. A. APPLICANT INFORMATION 1. Name Last First Middle Maiden Name (if any) 2. Mailing Address: (City) (State) (Zip) 3. Phone #: Home ( ) Cell ( ) _ 4. Address: Would you like to receive information, education events, program updates, and scholarship opportunities by ? Yes No 5. SSN # Enrollment # Date of Birth 6. Do you have any unpaid debts owing to any Education Division program? If yes, what is the debt and the amount owed? 7. Have you ever received any assistance through the Confederated Tribes of Grand Ronde Education Division? If yes, list the type of assistance and year. 8. Are you receiving assistance towards your education from any other Tribal program? If yes, list the program, caseworker, and amount B. EDUCATION INFORMATION: 1. Do you have: High School Diploma GED Year Completed (Provide a copy with your application) 2. Name of College You Wish To Attend: 3. College Accreditation Agency: (see accreditation section in the Full Time Program policy for an approved listing of regional accrediting agencies) The Confederated Tribes of Grand Ronde 2

3 4. College Financial Aid Address: 5. College Financial Aid Phone #: Fax #: 6. Have You Been Accepted For Admission: Yes No Pending (Provide documentation with your application) 7. Entry Term/Semester I will be a: 1 st year 2 nd year 3 rd year 4 th year 8. Program of Study: 10. Start Date: Expected Completion Date: 11. Operating System of the College: Term/Quarter Semester Other 12. Do you have limitations that would interfere with your successful completion of the program or degree? Yes No If yes, please explain. I, the undersigned applicant certify that the information I have provided in this application is true, complete and accurate. I understand that providing fraudulent information will subject this application to rejection and may affect any future funding eligibility. Applicant s Signature Date The Confederated Tribes of Grand Ronde 3

4 FUNDING ACCEPTANCE AGREEMENT Initial each section after reading. I hereby agree to attend the school indicated on this application and agree to follow all rules regulations and attendance requirements of the school. To the best of my ability I will satisfactorily complete the course work I have selected. I further agree that the funds issued to me for educational purposes will be used for such purposes. I agree that I will provide grade reports regarding my progress at the end of each term/semester. I will also provide a class schedule at the beginning of each term/semester I will be attending. I will provide updated contact information; including address, phone, and address to the Full Time College program staff whenever they change. I will also furnish other information as requested by the Full Time College Program staff in a timely manner. I understand that I am required to be enrolled FULL TIME and earn a minimum of 12 credit hours, or meet full time status per institutional standard. Graduate students must meet enrollment status as FULL TIME as set by the institution. Students must earn an equivalent to a minimum 2.0 Grade Point Average (GPA) per Term / Semester. I understand that if I do not meet the minimum academic requirements it will affect my funding. I understand that if I do not provide the Education Division with evidence of my progress, I will be required to REIMBURSE the Tribal Education Division for the funding advanced to me and I will not qualify for any further Tribal Education funding until I have reimbursed the Education Division in full. I understand that if I do not enroll, withdraw before the term / semester is over for any reason, drop out or receive a 0.0 GPA and/or 0 credits, for the grading period I will be required to REIMBURSE all awarded funds and I will not be eligible for additional funding until the amount is paid in full. Funding received may be taxable and thus reportable to the Internal Revenue Service. (School of attendance will send notification should this be that case.) I the undersigned have read, understand, and agree to abide by the terms and conditions of this Funding Acceptance Agreement. Print Name Tribal Roll Number Signature of Student Date The Confederated Tribes of Grand Ronde 4

5 EDUCATIONAL GOALS Short Answer Essay (attach additional sheets if necessary) *Information provided will not affect your application for funding. 1. Please list your intended college major and why you chose it. 2. How many credits do you need to complete your degree? 3. How many credits will you have to take per term/semester to complete your degree? 4. Have you met with an academic Advisor at your college to discuss your educational goals? If yes, list name and contact information of the advisor. If not, why not? 5. What kind of academic support services does your college provide to students? (example: TRIO, Educational Opportunities Program (EOP), Tutoring Center, Indian Education/Multicultural Office)_ The Confederated Tribes of Grand Ronde 5

6 EDUCATIONAL GOALS (continued) 6. What will you do to make sure you can meet the academic requirements of the program (earn at least a 2.0 GPA and 12 undergraduate or 9 graduate credits each term/semester)? 7. What is the total cost of attendance at your college for one academic year? (tuition, fees, books and supplies, room and board, transportation, personal/miscellaneous, childcare) How will you pay for it? 8. What are your short-term and long term career goals? 9. Do you anticipate working for the Confederated Tribes of Grand Ronde or Spirit Mountain Casino upon completion of your degree program? _ Please Explain:_ (your answer will not affect your funding this is for statistical data only) The Confederated Tribes of Grand Ronde 6

7 AUTHORIZATION FOR RELEASE OF INFORMATION The Confederated Tribes of Grand Ronde Education Division uses this authorization and the information obtained with it to administer and evaluate funding eligibility for its Full Time College programs. AUTHORIZATION: I do hereby authorize the release of any and all information regarding my case file as it relates to the eligibility / application for assistance from the Confederated Tribes of the Grand Ronde Community of Oregon, Education Division. This authorization includes and is limited to the following: Grade Reports, Transcripts, Progress Reports, and Updates Attendance Verification and Program Awards Financial Aid, Budget Summaries, Resources, and Scholarship Awards Personal Reports regarding program participation and/or requirements In addition, my signature allows the Tribal Education Division to release my case file information to the following agency / institution / person: CTGR Social Services Institute of Attendance Grand Ronde Tribal Housing Authority CTGR Member Benefits Other:(if you want your parents to receive this information you will need to list them here) I agree that photocopies of this authorization may be used for the purpose stated above. MY RIGHTS: I understand this authorization is voluntary and that I may revoke this authorization at any time, provided I do so in writing and submit it to CTGR Education, 9615 Grand Ronde Road, Grand Ronde, OR The revocation will take effect when CTGR Education received it, except to the extent that action has been taken in reliance on this authorization. _ Student Signature Social Security Number Date The Confederated Tribes of Grand Ronde 7

8 SCHOLARSHIP APPLICATION REQUIREMENT (Not Required for Vocational Students) It is the goal of the Full Time College Program to assist students in obtaining their college degree with as little debt as possible. With the increasing cost of attendance at most colleges and universities it is likely that students will be required to seek funding in addition to Tribal funding to pay for the cost of attending college. The Full Time College program requires students to apply for a minimum of one outside scholarship per year so students will have the opportunity to receive free money that can be used towards their college expenses and may reduce or eliminate the need for student loans. I hereby agree to submit documentation verifying that I have applied for a minimum of one outside scholarship separate from the Tribe for EACH academic year I am requesting funding. I agree to provide documentation showing that I have applied to a minimum of one outside scholarship to the Full Time Program prior to the first day of college classes for the term/semester for which I plan on attending. The following items are acceptable forms of verification: Scholarship Award Letter Scholarship Denial Letter Scholarship Submission Confirmation Page Copy of Completed Application I understand that if I do not provide the above required information, I will not receive Tribal funding. I the undersigned have read, understand, and agree to abide by the terms and conditions of the Scholarship Application Requirement. Print Name Tribal Roll Number Signature of Student Date Visit the Higher Education Section of the Tribal web site for information and links on scholarships: (this is a sample listing for scholarships and is not all inclusive) Contact the Tribal Scholarship Coordinator Luhui Whitebear at ( ) or by for additional information and resources. The Confederated Tribes of Grand Ronde 8

9 POLICY ACKNOWLEDGEMENT FORM I, have received and read a copy of the (Print name) Confederated Tribes of Grand Ronde Higher Education Programs Full Time College Program Policy dated September 9, 2013, which outlines the terms and conditions of the program as well as my responsibilities. I understand that if I do not fulfill the terms and conditions of the Full Time College Program Policy that I may be required to repay all funding that I have received towards my education. I agree to provide grades at the conclusion of each term/semester, and to provide class schedules at the beginning of each term/semester. I understand that if I fail to provide the required information that my funding may be delayed or canceled. I have familiarized myself with the contents of the Full Time College Program Policy. By my signature below, I acknowledge, understand, accept and agree to comply with the information contained in the Full Time College Program Policy. Roll Number (Student Signature) Date The Confederated Tribes of Grand Ronde 9

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